Individual
LYDIA RANDALL LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
930 MADISON AVE FL 6, MEMPHIS, TN 38103-3461
(901) 448-8393
Mailing address
116 ETHELYN SMITH DR, SENATOBIA, MS 38668-7403
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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